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Monday, May 9, 2011

Hood Robin: take from the poor and give to the rich!

There is a common notion in the Republican ideology that they believe the old, disabled, and the poor are costing this country too much money through entitlement spending, but no one has taken the time, Democrat or Republican, to address what the real issue is with entitlement health care spending.

Let’s go back to the source of the problem with Medicare and Medicaid. The problem is not about poor and old people not being able to pay their own way. Cutting these programs are punishing the most needy for the actions of the health-care industry as a whole.

It is a fact that the largest problem with Medical entitlements is the waste, fraud, and abuse, and further this government condones the legal fraud they commit (see my blog entry: Cost vs Price: "Health care providers make profits off the backs of the uninsured!" which explains this in detail).  Is this caused by the beneficiaries? NO. It is the health care providers and insurance companies who are the biggest offenders, but since they are the BIG part of big business, they are privileged and not held accountable for their fraudulent practices. Their industries rely on it in order to continually raise prices and the resulting profits. The problem with spending in these programs is for fictitious costs and price setting not only for health entitlement programs, but also health care industry wide.

It is a really sad state of affairs when our neediest and most destitute portion of Americans are being punished for the behavior of the health care industry. There is something really morally and legally wrong with this picture. In order to remedy our deficit and spending problem, our leaders are seeking to pick on a population that has absolutely no power or resources to do anything about the reduction in their care.  Those in power will seek to impose upon them a punishment in deference to a dishonest, fraudulent, yet profitable industry.

One thing I would like to see legislatively done industry wide is this: before health care providers are paid...

 1.) all bills sent to patients must be itemized along with a lay person's explanation of each entry and enclosed with a stamped and addressed envelope. 

2.) after submitting the bill to a third party payer for reimbursement (Medicare, Medicaid, Insurance companies, etc) each patient will receive a duplicate itemized bill sent to those third parties to corroborate that the itemized bill is correct and accurately describes the procedure and the associated costs.

3.) health care providers will not get reimbursed by third party payers unless or until the bill is corroborated by the patient.

This step would probably curb up to 50% of the fraud and abuse.

I am an uninsured individual and I had a routine mammogram. Something abnormal showed up on the film so I also had to get a sonogram (by the way, I am fine). 

I received 4 different bills for each procedure.  As a lay person, it looked like they kept re-billing me for the procedures.  I made a call to the person who deals with billing questions and found out these were each separate bills from each person involved in each process.  I could understand receiving 2 bills with all the corresponding technicians, radiologists, doctors, etc., from each facility (2), but they had separate bills for each one, which I received at different times.  They were all under the umbrella of the University Health Care system, so actually, it could have all been condensed into one bill.

The person I was talking to said she was hired by the University Health Care system and that her full-time job was to take calls from people who don't understand the billing.  This is wasteful and contributes to the cost of health care.

What happened to the idea of converting paperwork to a more efficient electronic system?

There needs to be more accountability from the providers and insurance industry side.  As it is, there is virtually none. The problem needs to be fixed at the industry level and the legal fraud that is occurring in the health care industry has to STOP, and stop trying to punish those who have no means of defending themselves.  They are the easy target and the path of least resistance!

Thursday, April 28, 2011

While You Weren't Looking...

While the national media has been inundated with the antics of the Donald and the Royal Wedding, the House Republicans have been very busy while we have been distracted.

It seems GOP politicians have made the defunding of what they term Obamacare (Patient Protection and Affordable Care Act) their primary focus of late, seeking to dismantle it piece by piece since they couldn't take it down through a complete repeal.A Reuters article posted on NewsDaily.com reported the House of Representatives passed a bill two weeks ago that would remove funding for a prevention and public health fund.  As early as next week another bill to defund grant money for school-based health centers will also be coming up for a vote.

Next week the House also will vote and probably pass a bill that would remove $1.9 billion in grants to states to fund the creation of state insurance exchanges so that individuals could buy affordable health insurance in their respective states.

The Congressional Budget Office (CBO) estimated that  eliminating grant funds to States would only reduce the deficit by about $1.5 billion per year over the next 9 years, but this would not eliminate the exchanges. The result of this action would shift the creation of exchange marketplaces to the federal government, which could cause an inflation of U.S. costs. Not much cost savings there. It appears to be only a temporary band-aid treatment.

So let's see what House Republicans have been accomplishing this year so far:

  • Extension of Bush Tax Cuts for the rich (passed)
  • Voted to extend Patriot Act (Congress passed a 90 day extension that will expire in May)
  • voted to block FCC's net neutrality rules (expected to fail in the Senate)
  • voted to block funding for IPCC (the definitive research institution for gathering information about the state of the climate)(expected to fail in Senate)
  • Voted to Cut Environmental Programs (failed in Senate)
  • Voted to cut spending by $61 billion (failed in Senate)
  • Voting to repeal the Affordable Health Care Act (failed in Senate)

Hmmm...so far, not so good.

And coming up, more attempts at dismantling Affordable Health Care with an almost certain failure at the Senate/Presidential level.  What have the Republicans done about jobs?

Hey Republicans...where's the jobs?